Blood Flow Restriction Therapy Expands at UH

Medical-grade tourniquet to restrict blood to the limbs during exercise produces strength gains of high-intensity training without the need of heavy loads

UH Clinical Update | February 2022

Patients who need to recover muscle strength after surgery, an injury or the muscle wasting of sarcopenia face a daunting challenge. The heavy loads of resistance typically used in strength training aren’t appropriate given their health circumstances, leaving them with a long road back to improved strength.

Fortunately, however, a rehabilitation therapy that overcomes these challenges is available – and is now offered at an expanded list of UH locations. Known as blood flow restriction therapy, it’s used by the Cleveland Browns, Cleveland Indians, Ohio State Buckeyes and now patients of UH Rehabilitation Services and Sports Medicine.

Here’s how it works: Physical therapists trained and certified in the technique briefly apply a specialized tourniquet to the patient’s arm or leg. Exercise with blood flow restriction allows the patient to rebuild the size and strength of the muscles while using significantly less weight. The treatment facilitates recovery and increases strength, ultimately getting post-surgical patients and patients with injury or arthritis back in action faster.

“This is an avenue to build a bridge between the time when you can’t really load, but you still want the muscle to grow and get stronger, and when you can start loading heavier again,” says UH physical therapist Ben Geletka, PT, DPT, Supervisor in UH Rehabilitation Services and Sports Medicine.

Geletka says that most of the patients UH physical therapists treat with blood flow restriction therapy are recovering from surgery or from an injury. However, he says there is evidence emerging of the therapy’s benefits for another, even larger group of patients -- older adults at risk of falls.

“It can be very beneficial for building muscular strength in the lower extremities of older individuals who are needing to increase their strength for a multitude of reasons,” he says. “Most importantly to us is to put them at less of a fall risk. There’s a good amount of research on aging population with sarcopenia. It’s been shown that instead of lifting weight, putting blood flow restriction cuffs on both legs and then having them walk on the treadmill at a prescribed rate will increase muscular thigh circumference with performance alone. For older patients at the highest fall risk, we have a harness system over a treadmill so they can be safe and supported if they were to lose balance.”

Blood flow restriction therapy has been offered at select UH locations since 2017. Recently, however, a core group of UH physical therapists were trained and certified on the equipment by an instructor from Owens Recovery Science, which provides the Delfi Personalized Tourniquet System (PTS) used at UH, in order to expand the therapy to more UH locations. The Delfi PTS is the only blood flow restriction unit that uses an internal Doppler System that continuously measures the patient’s individualized occlusion pressure during the entire treatment session.  

Because the Delfi PTS is an FDA-listed device, such training is required.

“We have multiple therapists across the UH system now who are certified in its use and they oversee its use in the clinics where the Delfi units are provided,” Geletka says. “The system itself is very self-monitoring, safe, easy to apply and consistent. It essentially measures how much pressure they’re supposed to have and then keeps it there consistently. I would say from a safety standpoint there’s not any safer system out there.”

As blood flow restriction therapy rolls out to more UH locations, Geletka says he hopes UH providers will increasingly consider it for their patients. To date, most referrals for the service have come from orthopedics and sports medicine.

The number of patients who could benefit is quite large.

“Most folks who can exercise or who can have surgery are eligible,” he says.

Blood flow restriction therapy is available at the following locations across the UH system. Please call the number listed for more information about referring a patient.